ASSISTED REPRODUCTIVE TECHNOLOGY (ART) SERVICES FOR DOD SERVICE MEMBERS AND THEIR SPOUSES: AN EIGHTFOLD PATH ANALYSIS
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Authors
Padgett, David A.
Subjects
assisted reproductive technology
ART
reproductive healthcare access
fertility assistance
infertility treatment
in vitro fertilization
IVF
active-duty service member
ADSM
embryo preservation
cryopreservation
egg freezing
fertility treatments
TRICARE
healthcare
Bardach
Eightfold Path
policy options
eligibility
manpower
retention
recruitment
equity
diversity
inclusion
quality of life
health
family planning
family building
financial burden
Department of Defense
DOD
ART
reproductive healthcare access
fertility assistance
infertility treatment
in vitro fertilization
IVF
active-duty service member
ADSM
embryo preservation
cryopreservation
egg freezing
fertility treatments
TRICARE
healthcare
Bardach
Eightfold Path
policy options
eligibility
manpower
retention
recruitment
equity
diversity
inclusion
quality of life
health
family planning
family building
financial burden
Department of Defense
DOD
Advisors
Heissel, Jennifer A.
Lester, Paul
Date of Issue
2024-06
Date
Publisher
Monterey, CA; Naval Postgraduate School
Language
Abstract
TRICARE excludes infertility treatment and assisted reproductive technology (ART) services, such as in vitro fertilization (IVF), for most active-duty service members (ADSM), creating negative downstream effects. Using Bardach and Patashnik’s Eightfold Path, this thesis qualitatively and quantitatively analyzes policy options for expanding healthcare coverage and eligibility of ART services for ADSMs and their spouses by assessing developed alternatives measured against selected criteria. It attempts to answer the following research question: What is the best policy alternative of expanding eligibility (who can get it) and coverage (how much is provided) of ART services for ADSMs and their spouses? This thesis compares four options for policy recommendation. First, to maintain the status quo. Second, to fully expand eligibility to all ADSMs and their spouses. Third, to limit coverage to only one round of IVF to all ADSMs and their spouses. Fourth, to limit eligibility to specific populations of ADSMs and their spouses (i.e., infertility diagnosis, genetic reasons, same-sex couples).The research indicates that adopting a policy that limits expansion of eligibility to specific populations of ADSMs and their spouses for ART services is superior. This policy promotes equitable reproductive healthcare access, enhances military recruitment and retention, improves the overall quality of life for ADSMs and their spouses, while balancing the DOD’s financial constraints.
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Thesis
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Distribution Statement
Distribution Statement A. Approved for public release: Distribution is unlimited.
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This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.